| NPI | 1063068203 |
|---|---|
| Former Name | ELIZABETH JOLENE FREDGANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135013) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 124871) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2023-08-02 |